基于新疆医疗大数据的结核流行病学、风险预警和疾病转归模型的研究

结核病发病率和死亡率高，是一个主要的全球健康问题，中国结核病新发患者全球排名第二，新疆作为中国高疫情地区，结核病感染情况底数不明，主要流行株分布、近期传播和耐药状况等尚不清楚。我们在获得2018年和2019年新疆全民体检大数据、喀什地区结核患者资料、标本的基础上，拟开展：1.新疆肺结核现患率、分布特征、危险因素研究，构建并验证结核病相关风险预警模型；2.以喀什地区涂阳肺结核患者为代表，进行MTB谱系鉴定、基因分型和测序，构建系统发育进化树和传播网络；3.综合结核患者临床资料、药敏结果、MTB基因分型等数据，筛选影响结核患者疾病转归的独立危险因素，建立结核病转归模型。掌握新疆结核感染的实际情况、推测MTB进化和传播机制、明确影响疾病转归的危险因素；通过结核病风险预警模型和疾病转归模型，实现结核诊断窗口前移，预警高危地区、高危人群、优化临床治疗决策，改善患者预后，为新疆结核病防控提供科学依据。

Tuberculosis(TB) is a major global health problem with high morbidity and mortality. The incidence rate of tuberculosis in China ranks second in the world. As a high epidemic area in China, the base number of tuberculosis infection in Xinjiang is unknown, and the distribution of major epidemic strains, recent transmission and drug resistance etc is unclear. On the basis of obtaining the data of national physical examination of Xinjiang in 2018 and 2019, the data and samples of tuberculosis patients in Kashi region, we plan to carry out:1.Study on the prevalence, distribution characteristics and risk factors of tuberculosis in Xinjiang, to build and validate early warning models of tuberculosis-related risks. 2.Take the smear positive tuberculosis patients in Kashi region as the representative, carry out the MTB pedigree identification, genotyping and sequencing, to conduct MTB lineage identification, genotyping and sequencing, and construct phylogenetic tree and spreading network. 3.Comprehensive clinical data, drug sensitivity results, MTB genotyping etc of TB patients Data, screening independent risk factors that affect the disease outcome of TB patients, and establishing a TB outcome model. To master the actual situation of tuberculosis infection in Xinjiang, to speculate on the evolution and transmission mechanism of MTB, and to define the risk factors that affect the prognosis of tuberculosis; Through the TB risk early warning model and disease outcome model, the TB diagnosis window can be moved forward to alert high-risk areas, high-risk populations, and optimize Clinical treatment decision-making, improve patient prognosis, and provide scientific basis for Xinjiang tuberculosis prevention and control.